oTrans-valvular pressure gradient and aortic valve area can be calculated by Doppler echocardiography.

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Cardiac Catheterization:

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Sometimes used to confirm the severity of AS and also to define the coronary anatomy, because concurrent coronary artery bypass surgery is often necessary at the time of aortic valve replacement in patients who have coronary disease in addition to their AS.

Treatment:

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Natural history of severe, symptomatic, uncorrected AS is very poor. (One year survival rate for patients with severe AS who don’t undergo surgery is 57%.)

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Only effective treatment for advanced AS is surgical replacement of the valve.

Percutaneous valvuloplasty: unlike in MS, where it works pretty well, it doesn’t work well in AS oBalloon dilatation across the aortic valve orifice can fracture fused, calcified valve commissures providing some immediate outflow obstruction relief…BUT 50% of AS patients then undergo valve RE-stenosis within 6 months.

oValvuloplasty in AS patients is only used for patients who are poor surgical candidates or as a temporary fix in patients who are too sick to go directly into AVR surgery.